Holding the rank of 51, or in other terms, dead last, the shortcomings of Indiana’s handling of elder care is subject to serious examination. Based on data from primarily 2016, AARP determined that Indiana received failing marks in two particular categories: affordability and access, and choice of setting. Hoosiers also saw themselves ranked last in support for family caregivers.

“I think that accessibility to affordable housing is always an issue with the elderly,” Maureen Widner, COO of Aging & In-Home Services of Northeast Indiana, said. “(As well as) having plenty of providers and choices when it comes to providers for services. And of course, the whole issue of caregivers and support for caregivers is a big one.”

Nowadays, there are multiple options for senior citizens to choose from. While some may seek out a facility where they can live and meet certain needs, others are opting to “age in place,” and remain in their homes.

“Seniors want to stay in their own homes versus going into an institution,” Widner said. “Nine out of 10 plan to stay in their home if they can. It makes sense to put money towards home- and community-based services.”

The popularity of this option is not reflected in the amount of Medicaid dollars contributed to such services. Indiana was cited by AARP on its scorecard as focusing more Medicaid dollars on funding institutions for long-term care or assisted living over home care services. In fact, according to AARP’s data, in 2014 less than 20 percent of Medicaid dollars in Indiana went toward home- and community-based care services.

As a result, those looking to take advantage of personal services that keep them in their home are often left footing most of the bill or being forced to move out of their homes and into an institution.

“Unfortunately, many have to go into institutions when it was not their choice,” Widner said. “A lot of times, it is less expensive to have services in someone’s home versus the costs of institutionalization. Money can be better utilized and more individuals can be served.”

Lutheran Life Villages has a handful of locations in the Fort Wayne area, serving about 350 residents currently plus many more receiving care from the company in their own homes. Tricia Neary, vice president of marketing and development, stated that some of its services, such as memory care, often see waiting lists of various lengths, but it doesn’t usually have a waiting list for its residential areas, save for the independent-living apartments.

Due to the personalized services tailored to each clients’ needs, Neary stated that the costs for each client can vary significantly. The costs of some of these long-term care or assisted living services can often be defrayed by waivers from Medicaid and other forms of compensation.

Working with Medicaid, though, can often raise additional issues for Indiana’s elder care service industry. In its score card for Indiana, AARP notes that Medicaid reimbursements in the state are rather low, and those reimbursements often have stipulations attached to them making it more difficult for the facilities to utilize those funds for present services.

“I think when you’re looking to a third party for something it always poses a challenge,” Neary said. “Medicaid focuses on quality so we work to keep our quality up.”

While elder-care service companies like Lutheran Life Villages may be worried about Medicaid, one thing it doesn’t seem too worried about is the potential influx of retired individuals over the next several years as the baby-boomer generation readies for retirement and utilizing services.

Neary pointed out that while baby boomers may be reaching retirement age soon, she expects that most of them won’t begin to seek out assisted living or home-care services until their 70s and 80s. This, Neary believes, gives companies and the industry as a whole a few years to prepare themselves and adjust their services to accommodate the pending surge of need for elder care services.

“I think it will be personal services that will (get) the biggest push from people because these baby boomers will want to stay in their homes and get the services they need,” Neary said “It’s getting more focused on individualized care as long as we continue to do that we’ll be able to meet people where they’re at.”